OBJECTIVE The Rare and Atypical Diabetes Network (RADIANT) will perform a study of individuals and, if deemed informative, a study of their family members with uncharacterized forms of diabetes. RESEARCH DESIGN AND METHODS The protocol includes genomic (whole-genome [WGS], RNA, and mitochondrial sequencing), phenotypic (vital signs, biometric measurements, questionnaires, and photography), metabolomics, and metabolic assessments. RESULTS Among 122 with WGS results of 878 enrolled individuals, a likely pathogenic variant in a known diabetes monogenic gene was found in 3 (2.5%), and six new monogenic variants have been identified in the SMAD5, PTPMT1, INS, NFKB1, IGF1R, and PAX6 genes. Frequent phenotypic clusters are lean type 2 diabetes, autoantibody-negative and insulin-deficient diabetes, lipodystrophic diabetes, and new forms of possible monogenic or oligogenic diabetes. CONCLUSIONS The analyses will lead to improved means of atypical diabetes identification. Genetic sequencing can identify new variants, and metabolomics and transcriptomics analysis can identify novel mechanisms and biomarkers for atypical disease.
This study describes the mental health of US adults with (PWD) and without (ND) diabetes during the COVID-19 pandemic. A 24-month web-based survey was administered from May 2020 (baseline, n=2,176) to June 2022 (24MO; n=1,172; 5 time points). Demographics, pandemic experiences, diabetes distress (DDS-17), depression (PHQ-8) and anxiety (GAD-7) symptoms, perceived stress (PSS-10), and resilience (BRS) were collected. On average, 24MO completers (53.1%) were 53 years (SD=16.4), primarily female (80.9%) and White (91.3%), highly educated (45.0% post-master’s degree), homeowners (72.7%), with an annual household income of ≥ $60,000 (62.2%). They were less likely to have a diagnosis of depression compared to non-completers (all p<0.05). Mental health score means (SD) were DDS= 2.2 (1.0; moderate), PHQ=4.9 (5.0; mild), GAD=4.0 (4.7), PSS=13.3 (8.0). At 24MO, type 2 diabetes (TD2) prevalence was 14% (167), prediabetes 7% (82), and type 1 4% (52; T1D). PWD showed higher levels of financial worry/distress compared to ND (all p<0.05). Similarly, PWD reported COVID as a greater personal health threat (range of means= 4.3-4.8) compared to ND (M=3.7, SD=1.8; p< 0.001). Greatest pandemic burnout was reported by T1D (M=2.9, SD=2.0) and lowest among T2D (M=2.0, SD=2.1; p<0.05). Across the 5 time points, measures of depression, anxiety, perceived stress and diabetes distress improved (all p<0.001). At 24MO, rates of personal COVID infection (33.0%), knowing someone with (93.7%) or who died from COVID (41.4%) increased compared to 12MO (first time point queried; 10.2%, 81.3%, and 34.1%, respectively; all p<0.001). However, financial concerns worsened. Difficulty paying bills increased (11.8% at 24MO v. 6.1% at baseline; p<0.001) and worsening financial appraisal increased (25.4% at 24MO vs. 17.1% at baseline; p<0.05). These data show that, despite improvements in mental health from the height of the pandemic to summer 2022, financial concerns persisted, particularly in those with diabetes. Disclosure B.A.Myers: None. R.Klingensmith: None. F.Anwar: None. I.G.Gonzalez casanova: None. M.De groot: Consultant; Barbara Kenner Family Foundation, Medscape, Mediflix, Inc.
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